Opioid Task Force Final Report Strategic Plan Opioid

Opioid Task Force Final Report & Strategic Plan

Opioid Task Force Leadership Co-Chair Scott Harrelson Co-Chair Tyler Harris Co-Chair Thomas Mark

Opioid Task Force Members � � � � Rebecca Anderson Bobby Aster Blake Belcher Gery Boucher Gwendolyn Bryan Scott Dacey Tina Davis Meghan Doyle Daren Fuller Tom Glasgow Katelyn Godley Fred “Chip” Hughes James Jenkins Jason Jones Jean Kennefick � � � � Jennifer King Stanley Kite Matt Knight Stanley Koontz Tharesa Lee George Liner Geoffrey Marett Carol Mattocks Theron Mc. Cabe Linda Mc. Coy Roger Merrill Sandy Merrill Jerry Monette Alison Newcombe Dave Peterson � � � � Stacey Rhodes Kevin Roberts Johnnie Sampson, Jr. Kehli Saucier Greg Singleton Dr. Michael Somers Amber Tabarrini Scott Thomas Joe Twilley Steve Tyson Diana Vetter Craft Jennifer Wagner Ira Whitford Alan Woodard Rick Zaccardelli

Catalyst for Opioid Initiative in Craven County � Dramatic increase in opiate related deaths in Craven County 30 25 20 15 10 5 0 2009 -2014 2015 2016 2017

Opioid Related Deaths in Craven County Date of Death Age F Gender County of Death 25 -Jan-09 80 Craven 29 -Jul-09 45 F Craven 25 -Aug-09 51 M Craven 22 -Sep-09 67 M Craven 10 -Mar-11 59 F Craven 16 -Mar-11 29 M Craven 16 -Feb-13 47 F Craven 17 -Nov-13 38 M Craven 10 -May-14 31 M Craven 26 -Jul-14 29 M Craven 28 -Sep-14 56 M Craven 26 -Apr-15 40 M Craven 21 -May-15 52 F Craven 21 -May-15 40 M Craven 4 -Sep-15 33 M Craven 7 -Sep-15 40 M Craven 14 -Sep-15 30 M Craven Drug Fentanyl, Ethanol Fentanyl, Pregabalin, Cocaine Fentanyl Heroin Oxycodone, Fentanyl Heroin, Ethanol, Oxycodone Heroin, Cocaine Fentanyl Heroin, Methadone Fentanyl, Cocaine, Ethanol Fentanyl Cocaine, Heroin Fentanyl, Cocaine Heroin, Cocaine, Ethanol Acetyl fentanyl

OPIOID Related Deaths 8 -Oct-15 18 -Dec-15 26 -Feb-16 1 -May-16 10 -May-16 52 29 21 28 33 34 M M M F Craven Craven 16 -May-16 56 M Craven 11 -Jun-16 33 M Craven 13 -Jun-16 39 F Craven 24 -Jun-16 5 -Jul-16 10 -Jul-16 19 -Jul-16 29 -Jul-16 12 -Aug-16 38 34 26 54 36 58 M M M F M M Craven Craven 22 -Aug-16 62 F Craven 9 -Oct-16 31 M Craven 16 -Oct-16 19 -Oct-16 31 49 M M Craven 4 -Nov-16 50 M Craven 8 -Nov-16 13 -Nov-16 48 24 M M Craven Heroin, Cocaine Fentanyl, Morphine, Ethanol Heroin Ethanol, Fentanyl Oxycodone, Furanylfentanyl, Heroin, Cocaine Fentanyl, Codeine Fentanyl, Oxycodone, Ethanol, Gabapentin, Diazepam Ethanol, Heroin, Fentanyl, Hydrocodone Oxycodone, Cocaine, Fentanyl, Alprazolam, Diazepam Fentanyl, Ethanol, Heroin, Furanylfentanyl, Cocaine Diazepam, Heroin, Fentanyl, Citalopram, Diazepam, Alprazolam Heroin, Furanylfentanyl, Fluoroisobutyrylfentanyl Clonazepam, Morphine, Citalopram, Furanylfentanyl Diazepam, Oxycodone, Lorazepam, Fentanyl, Morphine Heroin, Cocaine Heroin Ethanol, Fluoroisobutyrylfentanyl, Furanylfentanyl Hydrocodone, Fentanyl, Cocaine Heroin

Estimated Total Lifetime Costs Medical and Work Loss from Medication & Drug Fatalities All intents, 2016

Timeline of Opioid Initiative in Craven County � September 2017 Initial Forum � November 2017 Community Forums; Evaluation & Review of Forums � January 2018 Development of Plan to move forward � March 2018 First Task Force Co-chairs Meeting; Task Force Kick-off & Committees Assigned � April 2018 County joined national litigation against pharmaceutical companies April-November 2018 Committees met & developed recommendations �

Key Recommendations from Opioid Forum � � � Establish a working group to focus on prevention, while continuing to work with law enforcement agencies by providing for adequate resources Establish central coordination staffing for educating the public and coordinating resources Acquire bed space for long term treatment facility Provide for on-site referrals for rescued persons who choose not to go to the hospital Create more transitional housing Seek reversal of state cutbacks on Medicaid and state funded clients

Claims Against Pharmaceutical Companies � “Purdue Pharma Lawsuit Redactions Apparently Show Company Wanted To Capitalize On Opioid Addiction Treatment” A new report claims Purdue Pharma, the drug company accused of helping engineer and profit from the opioid epidemic, also considered expanding into addiction treatment. The Pro. Publica article is purportedly based on secret parts of a lawsuit filed by the state of Massachusetts against Purdue and members of the Sackler family who own the company. The suit alleges Purdue deceptively sold Oxy. Contin and downplayed its dangers. . .

Impacts of Opioid Crisis in Craven County � 1 -2 Number of newborns per month in 2015 at Carolina. East affected by substance abuse, up from 1 -2 per year in 2000. � $60, 000 Potential cost of extended stay at Carolina. East for addicted newborn � 93 Number of opioid pills person dispensed in Craven County in 2016 � 40 Percent of opioid related foster children cases in Craven County in 2017 -2018 � � � . As of early 2018 over 40% of foster children cases in Craven County had a direct connection to the opioid crisis In 2017 Carolina. East Emergency Department saw a rise in overdose cases by 1. 5 percent.

Opioid Task Force Structure The Craven County Opioid Task Force was organized into four working groups.

Objectives Adopted by Task Force Committees � Prevention through school based educational programming � Increase in number of medication drop boxes to discard unused and outdated meedications � Support for use of Narcan through local law enforcement/ first responders � Referral program as follow-up when Narcan has been dispensed, to ensure connection with the proper available resources

Opioid Task Force Objectives � Awareness campaign to understand nature of substance abuse and the available resources � Regional resource for short term detox and long term treatment � Potential addition of Licensed Clinical Social Worker to implement a jail diversion program and provide community counseling services � Access to all methods of medically assisted treatment (MAT).

Recommendations and Action Plan � Recommendations immediately translatable to action (no funding required): ØUse OD mapping software to help identify areas that are “hot spots” for drug interventions ØDeclare September as Opioid Abuse Prevention month in Craven County ØCreate educational campaign using county website and social media

Recommendations and Action Plan � Recommendations approval: contingent upon funding ØImplement a K-12 substance misuse curriculum ØDevelop and fund transitional care coordinator/jail navigator position ØDevelop and fund drug education coordinator position in conjunction with interdisciplinary mobile response teams for educating the public and advising overdose victims

Recommendations and Action Plan � Recommendations approval: contingent upon funding ØLaunch public service educational campaign to include paid advertising through mobile, print and electronic media ØSecure long term treatment facility ØExpand methods of Medically Assisted Treatment available

Selected Accomplishments Since Beginning of the Opioid Initiative � Placement of two more prescription drug drop boxes in the county � Additional Narcan funded and provided to law enforcement/first responders � Law enforcement regional partnerships established to enhance trafficking investigation operations � Regional short term detox facility developed � Licensed Clinical Social Worker position funded and created; tele-psychiatry services initiated in collaboration with Brody School of Medicine